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Chaihu-Shugan-San (CHSGS) is a herbal preparation that has been shown to effectively relieve neurologic impairment and reduce depression. However, the efficacy of CHSGS in the treatment of patients with epilepsy with depression is unknown. Therefore, in the present study, adult rats were exposed to chronic mild stress following the establishment of chronic pilocarpine-induced epilepsy. Subsequently, a sucrose consumption test and open-field test (OFT) were performed to assess depression-like behavior. Rats were randomly divided into four groups: Control, model, fluoxetine (1.8 g/kg) and CHSGS (2.7 g/kg) groups. The control and model groups received normal saline. The mRNA expression levels of the 5-hydroxytryptamine 1A (5-HT1A) receptor and the number of 5-bromo-2′-deoxyuridine (BrdU)-labeled cells in the hippocampal dentate gyrus were detected using reverse transcription-quantitative polymerase chain reaction and immunohistochemical analysis, respectively. Treatment administration was conducted by once daily intragastric perfusion for 28 days. The mRNA expression levels of the 5-HT1A receptor, the number of BrdU-labeled cells in the hippocampal dentate gyrus, the consumption of sucrose, and frequency of vertical and horizontal movement scores in the OFT were enhanced in the fluoxetine and CHSGS groups compared with the model group (P<0.05). However, no statistically significant difference was detected between the fluoxetine and CHSGS groups. These data suggest that CHSGS is able to increase the expression of 5-HT1A receptor mRNA and cellular proliferation in the hippocampal dentate gyrus in epileptic rats with depression, and thus effectively improve certain symptoms of depression.
Our aim was to investigate the value of rapid eye movement (REM) during prolonged scalp videoelectroencephalography (VEEG) in the localization of epileptogenic foci for patients with focal epilepsy. Method: We retrospectively studied a total of 59 patients with focal epilepsy and 31 of 59 received surgery. We assessed localization of interictal epileptiform discharges (IEDs) during REM, non-rapid eye movement sleep (NREM) and wakefulness to compare with the localization of ictal EEG, clinical semiology, magnetic resonance imaging (MRI) and positron emission tomography (PET) and stereo-electroencephalogram (SEEG). We graded postoperative follow-up outcome according to Engel criteria to further verify the accuracy of localization of epileptogenic foci in REM-IEDs. NREM-IEDs and Wakefulness-IEDs. Stepwise multiple logistic regression was carried out to assess for independent association of good prognosis with REM accurate localization, temporal lobe epilepsy and MRI accurate localization. Results: Clinical semiology was concordant to REM-IEDs in 40 patients (72.7 %), NREM-IEDs in 27 (49.1 %), and Wakefulness-IEDs in 25 (45.5 %). MRI lesion was concordant with REM-IEDs in 35 patients (81.4 %), Wakefulness-IEDs in 26 (60.5 %), and NREM-IEDs in 25 (58.1 %). PET localization was concordant with REM-IEDs in 20 patients (76.9 %), Wakefulness-IEDs and NREM-IEDs in 11 (42.3 %). SEEG localization was concordant with REM-IEDs in 15 patients (65.2 %), Wakefulness-IEDs in 10 (43.5 %), and NREM-IEDs in 8 (34.8 %). Thirty-one patients received surgery, and 30 (96.8 %) of them achieved good seizure control (Engel I-III). The surgical site was concordant with REM-IEDs in 23 (74.2 %), Wakefulness-IEDs and NREM-IEDs in 14 (45.2 %). In addition, the accuracy of REM-IEDs localization in temporal epilepsy (90 %) was higher than that extra-temporal epilepsy (45.5 %). REM accurate localization of epileptogenic foci was an independent factor contributing to good prognosis (P = 0.025, OR = 12.368). Conclusions: Compared with NREM-IEDs and Wakefulness-IEDs, REM-IEDs had most value for localization of epileptogenic foci in patients with focal epilepsy. REM-IEDs-accurate localization of epileptogenic foci was an independent factor contributing to good prognosis for postsurgical patients with focal epilepsy.
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